Last year, the Institute of Medicine issued a special report called Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The 500-page document called for major reform in the way care is provided to patients who are near death.
Surveys show that the majority of people state their preference is to die at home, and that they would choose a higher quality of life over life-extending measures when those two things are at odds. Yet according to the CDC, nearly 70 percent of Americans die in a hospital, nursing home or long-term-care facility. The IOM study suggests that advance care planning can not only ensure that the patient’s wishes are honored, but can reduce overall health spending by avoiding undesired and unnecessary interventions.
Often, the problem is that patients and their families have little guidance when it comes to navigating end-of-life choices. Let’s face it, doctors have had very little incentive to sit down and go over all the options with their patients in detail, taking into consideration the patient’s preferences and goals.
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